Decision Date: 10/12/95 Archive Date:
10/12/95
DOCKET NO. 93-22 779 ) DATE
)
)
On appeal from the decision of the
Department of Veterans Affairs Regional Office in
Manchester, New Hampshire
THE ISSUE
Entitlement to service connection for post-traumatic stress
disorder (PTSD).
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESSES AT HEARING ON APPEAL
Appellant and his wife
ATTORNEY FOR THE BOARD
P. Gutstein, Counsel
INTRODUCTION
The veteran served on active duty from August 1964 to August
1968, and from June 1971 to December 1977. He filed an
appeal from the October 1992 rating decision of the
Department of Veterans Affairs (VA) Manchester, New
Hampshire, Regional Office (RO), which denied service
connection for PTSD. The veteran filed a notice of
disagreement in December 1992, and he was furnished a
statement of the case in April 1993. He filed a substantive
appeal in May 1993. He and his wife were afforded a hearing
at the RO before a traveling member of the Board in
September 1993. The case was remanded by letter in April
1994. The veteran is represented in his appeal by the
Disabled American Veterans, which has submitted written
argument in his behalf.
At the veteran's personal hearing, it was stated that he
wished to file a notice of disagreement from the rating
decision of November 1992 in which 10 percent ratings were
continued for service-connected chronic strain of the
cervical and dorsal spine and for chronic low back strain
with osteoarthritis. It was also reported that the veteran
wished to file a claim for service connection for a
gastrointestinal disorder. The case was sent back to the RO
in April 1994 for the purpose of dealing with those issues.
However, a subsequent letter from the veteran that month
requested that his case be returned to the Board for the
purpose of having the issue of service connection for PTSD
completed. Accordingly, the other issues, which are not in
appellate status, are referred to the attention of the RO
for appropriate action.
CONTENTIONS OF APPELLANT ON APPEAL
It is argued that the veteran developed PTSD while stationed
in Vietnam when his base was attacked by the enemy,and
personnel at the base were killed, with this experience
representing life-threatening stressors. As a result, it is
further argued that the veteran was diagnosed after service
as having PTSD, resulting in recurrent nightmares, anxiety,
gastrointestinal reactions, and difficulty in concentrating
at his work.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991), has reviewed and considered all of the
evidence and material of record in the veteran's claims
file. Based on its review of the evidence in this matter,
and for the following reasons and bases, it is the decision
of the Board that service connection for PTSD is warranted.
FINDINGS OF FACT
1. The veteran served in Vietnam at an air base in which
stressful events, including enemy attacks with resulting
loss of life, occurred.
2. Early in December 1966, his base was under siege from
small arms fire and mortars followed by infiltration at the
work site by the enemy throwing satchel charges, while the
veteran was without a weapon to defend himself.
3. The veteran's feeling of helplessness when under enemy
attack in Vietnam because his MOS was not allowed to carry
weapons was considered a legitimate stressor which served as
a basis for a PTSD diagnosis by a VA examiner in November
1992.
4. The veteran has been medically treated for PTSD with
symptoms of anxiety and depression, requiring constant
medication, with manifestations of nightmares and sleep
disturbance, difficulty concentrating and other behavioral
disorders including withdrawal from society.
CONCLUSION OF LAW
PTSD was incurred in service. 38 U.S.C.A. §§ 1110, 5107(b)
(West 1991); 38 C.F.R. § 3.304(d)(f) (1994).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
Service connection may be granted for disability resulting
from disease or injury incurred in or aggravated by wartime
service. 38 U.S.C.A. § 1110 (West 1991).
38 C.F.R. § 3.304(d) (1994) provides that satisfactory lay
or other evidence that an injury or disease was incurred or
aggravated in combat will be accepted as sufficient proof of
service connection if the evidence is consistent with the
circumstances, conditions or hardships of such service even
though there is no official record of such incurrence or
aggravation. 38 C.F.R. § 3.304(f) (1994) provides that
service connection for PTSD requires medical evidence
establishing a clear diagnosis of the condition, credible
supporting evidence that the claimed inservice stressor
actually occurred and a link, established by medical
evidence, between current symptomatology and the claimed
inservice stressor.
The evidence in this case shows that the veteran served on
active duty from August 1964 to August 1968 during which
time he served almost 12 months in Vietnam, and from June
1971 to December 1977. The records otherwise show that the
veteran's classification was as an aircraft and jet engine
mechanic and that he engaged in the Vietnam air offensive
campaign from September 1966 to March 1967 stationed at Tan
Son Nhut Airbase. The length of his foreign service was
from September 1966 to September 1967. In connection with
his claim, the veteran submitted copies of newspaper
articles showing raids on Tan Son Nhut Air Base by the Viet
Cong with mortars. A report from the United States Army and
Joint Services Environmental Support Group (ESG) dated in
October 1992 confirms that on December 4, 1966, the above-
cited air base suffered a hostile mortar attack and as a
result 27 airmen were injured and three were killed. Also
enclosed with this report were abstracts of reports
indicating the dates of attacks on this air base during the
veteran's Vietnam tour of duty and that during the December
4, 1966, attack 20 aircraft were damaged.
The veteran filed a claim for service connection for PTSD in
December 1991. Subsequent medical reports show VA
outpatient treatment for anxiety and depression in the early
1990's. A VA psychiatric examination report in August 1992
showed that the veteran had prior employment at a naval
shipyard until 1986 and that he had difficulties with his
co-workers and quit with no gainful employment since then.
He reported a history of diarrhea for 25 years,
restlessness, nervousness, inability to concentrate,
nightmares about Vietnam, becoming easily angry, irritable,
light sleep only and alerted by noises, overreactive, easily
jumpy, occasionally depressed and avoidance of people.
Objectively, he appeared tense, his speech was somewhat
under pressure, his posture was somewhat stiff and he was
not able to relax completely throughout the examination.
His facial expression showed some tension and anxiety. The
exa.miner diagnosed moderately severe PTSD. It was noted
that he was intensely psychologically distressed at exposure
to events that verbalized or resembled aspects of the
traumatic event which was being overrun by 300 Viet Cong and
not having weapons to defend himself; fear of being shot at
and a feeling of helplessness. He avoided thoughts or
feelings associated with the trauma and avoided activities
and situations that aroused recollections. He had markedly
diminished interest in significant activities. He had lost
interest in his hobbies of fishing and hunting. He was
socially isolated and felt somewhat detached. He had a
startle reflex and a light sleep to be "on alert." He
suffered from irritability or outbursts of anger and
exaggerated startle response.
On a subsequent VA psychiatric examination conducted in
November 1992, the veteran complained of increased anxiety
and depression since service but had considered this
"normal" and had avoided seeking help. He finally sought
help at the mental hygiene clinic. He described his most
traumatic episode in Vietnam as being when the Viet Cong
tunneled under the perimeter and infiltrated his base. He
was in a bunker and saw a number of the enemy go by. What
was most distressing to him of all was that he was unarmed
because of Air Force policy that servicemen in his position
should not carry weapons, but instead were to be protected
by the Air Force police. As the infiltration was occurring,
he recalled that the enemy fired mortar rounds from within
the compound. He saw a number of GI's crying, and others
drinking to calm down. He said he was not really too scared
until the sun came up at which time he saw the bodies of
several enemy dead, collected during the night's activities,
which upset him greatly. He also described other traumatic
events during his service in Vietnam as having to walk by
the morgue on his way to the chow hall and seeing American
dead piled up on the tables. This sight made him lose his
appetite and his weight went down from 190 to 155 pounds.
The examiner concluded that the veteran had recollections of
an event in Vietnam during which he legitimately appeared to
have felt quite helpless, apparently serving as a basis for
the PTSD diagnosis.
The veteran testified at his September 1993 personal hearing
concerning the service events in Vietnam, described above,
and post service events including a record of current
treatment for PTSD every two weeks. He was taking various
medications for his psychiatric disability and for other
problems. His wife also testified indicating his strange
behavior including the fact that the veteran has had
recurrent diarrhea, she witnessed his nightmares, reported
he kept loaded weapons in the house including one under the
bed, and that after an episode of nightmares, he would lock
himself in his bedroom.
Also received in September 1993 were statements in support
of the veteran's claim including one from R. F. R., a
"buddy" of the veteran who knew him before service and also
knew him overseas in Vietnam. He knew that the veteran
worked on the flight line on the midnight shift and recalled
on the night of December 3 and morning of December 4, 1966,
the base was attacked with mortars, satchel charges,
grenades and sappers which had infiltrated across the
runway. He saw the veteran after the attack and the veteran
seemed a bit shaken but was mad because he did not have a
weapon during the attack. He showed R. F. R. the bunker he
was in, right in the midst of where the Viet Cong were
killed. You could still see the blood on the cement of the
flight line. Another statement from L. M. H., also received
at the same time, concerned his knowledge of the veteran's
experiencing diarrhea and an inability to control himself
when visiting L. M. H.'s home in May 1973. The veteran
explained that he got that way when he was under stress.
In the United States Court of Veterans Appeals (Court)
decision of Zarycki v. Brown, 6 Vet.App. 91 (1993), the
Court noted that it is the distressing event rather than the
mere presence in a "combat zone" which may constitute a
valid stressor for purposes of supporting a diagnosis of
PTSD. It emphasized the importance of an event during such
service "that is outside of the range of usual experience
and that would be markedly distressing to almost anyone,"
such as experiencing an immediate threat to one's life or
witnessing another person being seriously injured or killed.
In the case at hand, the veteran has described an event
where the enemy attacked an air base where the veteran was
stationed at night in early December 1966 with resulting
loss of considerable life of the enemy as well as the
wounding of American soldiers and the death of at least
three soldiers, and damage to the air field. In such event,
the veteran experienced stressful events because he was
unarmed, and apparently angry and scared that he was unable
to defend himself, with the situation later magnified by
viewing of both American and enemy dead in a place set aside
for a mortuary. The official service records have indicated
that this was a combat zone for the period from September
1966 to September 1967 and the veteran has indicated that he
was otherwise subject to stressful attacks from the enemy.
His description of the events has been confirmed by a
"buddy" of his. A post service diagnosis of PTSD has been
confirmed by VA doctors and the veteran has demonstrated
classic symptoms of this mental disease including startle
reaction, bad dreams, irritability, anger, anxiety,
depression, social isolation and difficulty in working with
others. In Doran v. Brown, 6 Vet.App. 283 (1994), the
Court, citing the Zarycki case, supra, noted that there was
nothing in the statute or in the regulations which provided
that corroboration of the stressors must and can only be
found in service records.
The record establishes that PTSD was incurred in service.
38 U.S.C.A. §§ 1110, 5107(b) (West 1991); 38 C.F.R. §
3.304(d)(f) (1994).
ORDER
Entitlement to service connection for PTSD is granted.
G. H. SHUFELT
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740,
___ (1994), permits a proceeding instituted before the Board
to be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting
less than the complete benefit, or benefits, sought on
appeal is appealable to the United States Court of Veterans
Appeals within 120 days from the date of mailing of notice
of the decision, provided that a Notice of Disagreement
concerning an issue which was before the Board was filed
with the agency of original jurisdiction on or after
November 18, 1988. Veterans' Judicial Review Act, Pub. L.
No. 100-687, § 402 (1988). The date which appears on the
face of this decision constitutes the date of mailing and
the copy of this decision which you have received is your
notice of the action taken on your appeal by the Board of
Veterans' Appeals.
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